Individual provider Active NPI

Roseline Carelus, NP

  • Adult Health Nurse Practitioner
  • Freeport, NY
National Provider Identifier
1760699060
Registry record updated Nov 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F305252 Issued in NY
Practice address
309 Lena Avenue
Freeport, NY 11520
Phone
(516) 662-3979
Fax
(516) 379-4879
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 428863 NY
Adult Health Nurse Practitioner 363LA2200X F305252 NY Primary

Addresses

Primary practice location

309 Lena Avenue
Freeport, NY 11520

Mailing address

309 Lena Avenue
Freeport, NY 11520
Phone (516) 662-3979

Other identifiers 1

IdentifierTypeStateIssuer
428863OtherNYNY STATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170309001701 NY Practitioner - Nurse Practitioner 8729362801 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harmony Health Care Long IslandGroup PAC ID 5991970535, 24 clinicians

Practice addresses (Care Compare)

101 S Bergen PL
Freeport, NY 11520-3528
Phone (516) 623-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
428863NYMDRegistered Nurse
F305252NYMDAdult Health Nurse Practitioner

Practice roles (5 of 9)

OrganizationSpecialtyStatusNew patients
Matrix Medical of New York PC CurrentSince Feb 1, 2017 Accepting new patients
Harmony Health Care Long Island CurrentSince Sep 8, 2019 Accepting new patients
Harmony Health Care Long Island CurrentSince Sep 8, 2019 Accepting new patients
Harmony Health Care Long Island Current Accepting new patients
Elmont Community Health Center Past Accepting new patients

Locations

101 S Bergen Pl
Freeport, NY 11520
Phone (516) 623-3600

135 Main St
Hempstead, NY 11550
Phone (516) 292-3111

1740 Broadway
Fl 15
New York, NY 10019
Phone (201) 256-5032

380 Nassau Rd
Roosevelt, NY 11575
Phone (516) 571-8200

1600 Stewart Ave
Ste 300
Westbury, NY 11590
Phone (516) 546-4209

424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: roseline.carelus@lifqhc.eclinicaldirectplus.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385337600000",
    "number": "1760699060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 LENA AVENUE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "11520",
            "telephone_number": "516-662-3979",
            "fax_number": "516-379-4879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 LENA AVENUE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "11520",
            "telephone_number": "516-662-3979",
            "fax_number": "516-379-4879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARELUS",
        "first_name": "ROSELINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2013-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "428863",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LICENSE NUMBER",
            "identifier": "428863",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

Verify at the official NPI Registry.